When lying down in bed, the movement of getting the patient's legs up in bed is heavy. The patient may have big difficulties doing this by themselves due to reduced strength. If this manoeuvre is performed by the nurse, she or he is lifting the weight in a difficult height and position.
In particular, persons having mobility, strength or other limitations hindering them from coming from a sitting position to a lying position, or vice versa, on a bed will need help to perform this task. At settings where a carer helps to carry out this task daily, be it in a hospital, special care centre or a home and the carer being a nurse or another professional person or a relative to the person to be helped, this person will be exposed to a number of operations putting their health at risk, such as for example overload of the muscles and/or back. The reasons for the potential risks are several individual factors or combination of factors. For example a difference in length of the person to be helped and the carer will result in non-optimal working posture. Another factor is the difference in weight giving unequal load between the persons. Factors such as the working height might have severe effects on the carer since it affects the carer's reach and thus possibly making the carer twist their back to compensate. A low working height will lead to a bent back of the carer, resulting in very high loads on the lower back. Another factor affecting the reach comes from the width of the bed and the fact that the legs of the person to be helped legs have to come from the lying position relatively far in from the edge of the bed and out onto the edge of the bed for the carer to be able to help them down onto the floor and vice versa when coming from a sitting position to a lying position on the bed.
There is also a number of factors affecting the person to be helped that can have a negative effect. Such factors include, for example, the need to have a straight back during the manoeuvre from sitting to lying or vice versa, which can be hard to maintain without proper technique and/or equipment, also the need to have the patient's legs and upper body substantially parallel in the sagittal plane, which is hard to maintain without proper technique and/or equipment.
Shear of the skin may also be an issue for the person to be helped if no proper technique and/or equipment are used. The person to be helped may also be affected by the speed of the transition from sitting to lying or vice versa if it is not timed to the patient's conditions or preferences.
Another factor that can affect the person to be helped is the amount of activity that person contributes with throughout the manoeuvre. If the carer chooses to use a technique and/or equipment that makes the person to be helped more passive than necessary that will have a negative influence on that person's mobility level progression.
When the person helped has come from the lying position in bed to the sitting position at the edge of the bed, in many cases the person is also in need of help in the sit-to-stand sequence that generally follows.
An important factor of beds intended for persons in settings like elderly care facilities, special care clinics and hospitals or similar, is their ability to reach a very low position when the person is left unattended, preferable in order to minimize the consequences from an unintentional fall from the bed onto the floor. Another factor is the fact that a bed is a medical device which must meet regulations, and accessories not sanctioned by the manufacturer may not only hinder the bed's specified functionality but may also compromise the safety of the bed.
Not only are there personal gains in limiting the negative factors, there are also economical as all the negative factors have consequences that can be measured in economic terms, be it for the employer employing the carer having to reimburse the employee for conditions acquired due to lack of proper working technique and/or equipment provided or the prolonged rehabilitation of a patient that has been passivized.
Various known devices have sought to address the problem of a patient coming from a sitting position to a lying position at a bedside. For example, US 2004/0019967—“Assistance apparatus for assisting a person into and out of bed” discloses a device that the patient sits on and, while leaning onto the movable upper frame, their legs are elevated by the lower frame following the movement of the upper by the powered movement. Some drawbacks with the described device can be noted. It's design around a chassis intends it to be permanently installed adjacent the bed frame, which complicates use together with modern hospital beds that are height adjustable and have safety gates that need to be operable in the same area as the device occupies. With a chassis between the person's calves and the bed it will become even harder to come to the ideal position in the centre of the bed when lying down, since the starting position is further out than without a chassis adjacent to the bed. The person to be helped is also fully dependent on the apparatus in that it is powered in the motion, potentially leading to a more passivized person than needed.
Another device is disclosed in US 2010/0125947—“Leg Lifting Apparatus”, where the person's legs are lifted onto the bed while sitting on the horizontal part of the bed. The device again mainly focuses on an independent person, this time having enough muscular tonus to handle the upper body movement personally. As the device is intended to be permanently mounted to the bed, it can be in conflict with the normal performance of the medical bed and can also be a hindrance to the following sit-to-stand movement if this is carried out with the help of a mobile device such as a sit-to-stand device having a chassis extending partly under the bed.
Yet another device is disclosed in U.S. Pat. No. 6,349,433 “Assembly of a bed and an apparatus for movement support for a person when moving into or out of a bed” where the person is helped with upper body movement by a lever.
Known devices, such as height adjustable beds, are a great help in providing an ergonomic workplace even with people of different length. Such beds are also known to have profiling features, in that they are able to raise the backrest helping the person come up to a more sitting position, and can minimize the physical demands of the carer. This sitting position is in the centre of the bed, facing towards the foot end of the bed and does not address the sometimes important need of having the legs and upper body parallel in the sagittal plane when coming from a lying position to a sitting position on the edge of the bed facing out from the beds longer side. Nor gives it any help in getting the legs up into the bed when going from a sitting position at the edge of the bed into a lying position. Another potential drawback is the fact that the speed of the backrest is fixed and does not adapt to the person's specific needs and/or preferences.
Patient lifters such as U.S. Pat. No. 6,557,189 may be able to minimize the load the carer is exposed to in the process of helping a person in coming from a lying position on a bed and up from the support surface, in that they are lifted in a sling with motorized help. The device may also re-position the person to a sitting position and deliver the person down to the edge of the bed. The biggest drawback of using this kind of device for this sort of manoeuvre is that the person helped out of the bed is forced to be very passive in this manoeuvre. Secondly, it is a very time consuming process.
The prior art devices can also have the drawback of being awkward to use with other patient transfer devices, such as a Sit-to-Stand device.
The present invention seeks to provide an improved patient repositioning device and method.